893 (36%) died, and 273 (9%) were institutionalized. click here The maintenance of exceptionally good health among the elderly
participants was related to younger age at baseline, socioeconomic status (higher income), psychosocial factors (including lower psychological distress), and behavioral factors (never smoked and moderate alcohol use).
Conclusions. The maintenance of exceptionally good health in old age is related, at least in part, to modifiable lifestyle factors. However, elevated socioeconomic status also distinguishes those who are able to maintain exceptionally good health.”
“Background. Nursing home (NH)-acquired pneumonia (NHAP) causes excessive mortality, hospitalization, and functional decline, partly because many NH residents do not receive appropriate care. Care structures like nurse/resident staffing ratios can impede or abet quality care. This study examines the relationship
between nurse/resident staffing ratios, turnover, Ferrostatin-1 and adherence to evidence-based guidelines for treating NHAP.
Methods. A prospective, chart-review study was conducted among residents of 16 NHs in three states with >= 2 signs and symptoms of NHAP during the 2004-2005 influenza season. NH medical records were reviewed concurrently for functional status, comorbidity, NHAP severity, and guideline adherence. Ratio of licensed nurse and Certified Nursing Assistant (CNA) hours per resident per day (hrpd) and ratio of newly hired nursing staff/year to current nursing staff
were provided by Directors of Nursing. Associations among guideline adherence, nurse and CNA hrpd, and turnover were assessed using multiple regression to adjust for case mix, facility characteristics, and clustering of residents in facilities.
Results. Mid (1.7-2.0) and Eltrombopag high (> 2.0) CNA hrpd were significantly associated with better pneumococcal and influenza vaccination rates. More than 1.2 licensed nurse hrpd was significantly associated with appropriate hospitalization (odds ratio [OR] 12.4: 95% confidence interval [CI], 3.5-43.8) and guideline-recommended antibiotics (OR 3.8: 95% CI, 1.7-8.7). A > 70% turnover was inversely related to timely physician notification (OR 0.4: 95% CI. 0.2-0.7) and appropriate hospitalization (OR 0.09: 95% CI, 0.05-0.26).
Conclusions. NHAP treatment guideline adherence is associated with rtursc and CNA hr-Ixl and stability. An NI-I’s ability to implement evidence-based care may depend on adeqtnnc staffing ratios and stability.”
“Background. In older adults without clinical cardiovascular disease, coronary artery calcium (CAC) is associated with other subclinical vascular diseases, which, in turn, predict physical dysfunction. However, the association between CAC and physical function is unstudied.
Methods. In 387 older community-dwellers from the Cardiovascular Health Study without clinical cardiovascular diseases (mean age +/- standard deviation = 78.7 +/- 3.7, 35% men, 22% African Americans).